I'm currently in my 2nd year of a Masters social work course and thinking of doing a dissertation on the transition into an elderly residential home from independent living and how a social worker's role fits into this, the person's experience of the transition and their experience of the social workers input. Also whether earlier involvement with a social worker in the elderly person's life (instead of involvement at the crisis stage- i.e. moving into residential home) could have enabled them to live independently for longer? I'm guessing interviews with elderly people who have gone through this tansition (making sure I address any ethical issues) and thematic analysis. I'm also assuming I should use residential homes as opposed to care homes/palliative care?
Another option was ageism in society/media but I'm torn between what to choose.
Does anybody have any thoughts on the subject or advice? would be much appreciated.
Thankyou!
Hi Emma,
My 1st social work placement was working with older people in residential/nursing care and there were a few things that I found interesting that you may want to consider?
- Ageism in the context of group care- does this mean that just because you're old you have to put up with 'going into a home'?
-In an age of personalisation, shouldn't we be doing more to support people and their wishes more by keeping people living in the community for as long as possible? I say this because of all the older people I worked with, hardly ANY OF THEM (still with capacity) would have chosen residential care as a living option if they still could have lived at home with more support.
- In relation to council cost ceilings, are social workers over a barrel in how much they can realistically do to stop someone going into care? (where I work, if you get much more above 4-5 double handed calls a day, the council will start breathing down your neck about resi care).
- Looking at nursing care/palliative beds/residential beds could be interesting in terms of contrasting the social and health care tension- where does one need stop and another start?
-Recently, there has been some talk of how councils treat people who fund their residential care themselves- could there be more social work input there?
-What about 'reverse' moves? I supported a service user who had had enough of resi care and moved back into the community- this is unusual but does happen.
If I can help in any other way, please do contact me.
And good luck! I salute for you looking into this issue!
Have been doing some research for a project I'm working on and came across a document called 'People who pay for care: quantative and qualitative analysis of self-funders in the social care market' - there's some really interesting excerpts from interviews with older people about their feeling around entering residential care which might be worth a read - the qualitative bit of the document comes from the Journeys without maps piece of work completed by Melanie Henwood Associates. Might be worth a google?
The first question is whether the person (or their family) can fund themselves to pay the residential home fees.
This is an extremely important question, and can determine the quality of home they go to.
secondly there can be biog difference between medical opinion and social worker opinion. Maybe that is an argument on who is going to pay.
Hey,! Thankyou! I will have a look, sounds very useful :) and thanks hamster52 for your reply, I've only just seen it as I don't log on often, but I'm going to start!..Cheers
Interesting subject, especially at this time of cuts etc. You are right about ethical issues being important and perhaps even more so with people who might lack capacity to agree to be interviewed. You need to be sure that whatever methods you use have been accepted by something like an ethics committee (though I wouldn't wish that experience on anyone!) I'm sure your uni/department has some guidelines.
An interesting question might be around what the people were expecting residential care to be like. When I first started, some older people equated residential care with the workhouse and were not at all keen, but were (sometimes) pleasantly surprised at what they found.
Hello!.
Yes I'm only interviewing people who have capacity, as It wouldn't be ethical to interview those who lacked capacity and it wouldn't be useful to my research....I've sorted all that out, gaining permission from residential home manager, consent forms etc, I'm using independent residential homes not NHS etc so have bypassed the ethics committee, just the uni one.
Yeah that sounds like a good question to include...If you think of any others don't hesitate to let me know, hehe!
Thanks for your reply!
Paul Barton has made a very valid point- the tension between medical and social work opinion. The number of times an older person has been "promised a lovely little residential home" by a doctor to then be told that this isn't going to happen by the social worker! From my experience, doctors don't have a very enabling attitude sometimes and feel that older people taking risks isn't acceptable.
Tension also between who pays- the Local Authority or NHS (through Continuing Healthcare). You could have people in neighbouring rooms within a home who are paid for from different funding streams- interesting stuff I reckon.
hamster52: Paul Barton has made a very valid point- the tension between medical and social work opinion. The number of times an older person has been "promised a lovely little residential home" by a doctor to then be told that this isn't going to happen by the social worker! From my experience, doctors don't have a very enabling attitude sometimes and feel that older people taking risks isn't acceptable. Tension also between who pays- the Local Authority or NHS (through Continuing Healthcare). You could have people in neighbouring rooms within a home who are paid for from different funding streams- interesting stuff I reckon.
The figures in the business case for the project I'm working on are that nearl 50% of admissions into a residential care setting (either with or without nursing) are direct from an acute healthcare setting. Informal evidence suggests that the group where we are working still has noteable numbers of people going into residential "because the doctor told me I had to" or "because the doctor told me I couldn't go home". We had some workshops with financial advisors who work with older people / later life funding and they reported that over 80% of their referrals come from family members rather than the individual - it really suggests that choice and alternative options really aren't being promoted for this vulnerable group.
As an aside, the Money Saving Expert forum is worth a look - the Over 50's forum has threads about funding social care - very interesting IMO http://forums.moneysavingexpert.com/forumdisplay.php?f=26
Hi,
I am a first year social work student. With reference to your statement about referrals coming from family members, where could i get evidence to support this?
I am currently writing an assignment on older people and how social worker can best assist older people in their chosen lifestyle? any info or statistics would be useful if you are familiar with this area.
Many thanks
Hi - the evidence was anecdotal from workshops with a small group of Independent Financial Advisors - however if you google SOLLA or Partnerships, you might find some more information.
Mrs Nice, I would make reference to the Mental Capacity Act 2005- older people have the right under the law to make their own decisions if they have the capacity to(even if thought to be unwise or against family wishes).
Social workers have the responsibility to support their clients and their wishes- the right to self-determination is very important.
However I have found that in reality, that some older family members don't want to be a burden to their children and therefore accept their children's "recommendation" to go into a home. I hasten to add that as a social worker, I don't endorse these "recommendations" very often!
I saw a service user last week who had a care package of 45 mins A WEEK and her son wanted her to go into resi care. I had to firmly say that it wasn't going to happen (the SU wanted to stay at home and was living happily and safely there!)
KJX- your info on older people being "told to go to resi care" or "told they couldn't go home" is worrying and interesting to see that this is still going on in the NHS. Makes me so mad!!
hamster52: KJX- your info on older people being "told to go to resi care" or "told they couldn't go home" is worrying and interesting to see that this is still going on in the NHS. Makes me so mad!!
I think what makes me sadder is the (anecdotal - although I have asked today for the IFA's to give me some figures) fact the person in receipt of the care seems often not to be the decision maker.
Although - have a look at some of these threads - fascinating reading
http://forums.moneysavingexpert.com/showthread.php?t=425510http://forums.moneysavingexpert.com/showthread.php?t=3132712http://forums.moneysavingexpert.com/showthread.php?t=2961894